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Eiji Itoi - One of the best experts on this subject based on the ideXlab platform.
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effects of joint Capsular Release on range of motion in patients with frozen shoulder
Journal of Shoulder and Elbow Surgery, 2020Co-Authors: Yoshihiro Hagiwara, Akira Ando, Masashi Koide, Kenji Kanazawa, Takuya Sekiguchi, Yutaka Yabe, Kazuaki Suzuki, Eiji ItoiAbstract:Background A thickened joint capsule is believed to be one of the most specific manifestations of and the primary restraint against range of motion (ROM) in frozen shoulders. The purpose of this study was to evaluate the relationship among ROMs under general anesthesia before surgery and the effects of each joint Capsular Release on ROM. Methods ROM was measured using a goniometer with scapular fixation. Arthroscopic pan-Capsular Release was performed with the patient in the beach-chair position in the following order: (1) rotator interval, (2) coracohumeral ligament, (3) superior capsule, (4) middle glenohumeral ligament, (5) anterior inferior glenohumeral ligament, and (6) posterior inferior glenohumeral ligament. ROMs in forward flexion (FF), lateral elevation (LE), external rotation with the arm at the side (ER1), external rotation at 90° of LE (ER2), internal rotation at 90° of LE (IR2), horizontal flexion, external rotation at 90° of FF (ER3), and internal rotation at 90° of FF (IR3) were evaluated before and after each Release. Results A total of 32 consecutive shoulders were included. After each Capsular Release, the ROM recovered; the final ROM was significantly greater on the affected side than on the unaffected side. Significant correlations were found between FF and LE, FF and ER1, ER1 and ER2, ER1 and ER3, ER2 and ER3, and IR2 and IR3 on both sides, regardless of surgery. Conclusion Each segment of the joint capsule affected ROM in all directions, supporting the need for whole-joint Capsular Release; ROM was significantly greater on the affected side than on the unaffected side after surgery.
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solitary bone cyst of the proximal humerus with a concomitant stiff shoulder treated with both arthroscopic Capsular Release and arthroscope assisted resection of the bone cyst a case report
Open Journal of Orthopedics, 2018Co-Authors: Akira Ando, Masashi Koide, Yoshihiro Hagiwara, Michimasa Matsuda, Eiji ItoiAbstract:Solitary bone cysts are benign bone lesions that usually occur in the humerus, calcaneus, and femur of children and adolescents. When present in adults, they are usually diagnosed as incidental findings. In this report, we present an adult case of a solitary bone cyst of the proximal humerus with concomitant refractory stiff shoulder treated with both arthroscopic Capsular Release and arthroscope-assisted resection of the bone cyst. A 73-year-old woman was referred with a complaint of persistent left shoulder pain and limited range of motion. Magnetic resonance imaging showed an approximately 4.5-cm long diameter cystic bone lesion from the humeral neck to the shaft. At first, arthroscopic synovectomy and pan-Capsular Release were performed. Next, two 1-cm skin incisions and 8-mm drill holes into the lateral wall of the cyst were created with fluoroscopic guidance. After insertion of the arthroscope through the holes, the white membranous cyst wall was resected with a shaver until bone marrow was observed. Finally, an 8-mm cannulated hydroxyapatite pin was inserted. This is a simple technique that allows direct visualization and complete resection of the cyst wall with two small incisions. Such a technique may be superior to conventional open procedures or those under image guidance.
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effects of intra articular steroid injection before pan Capsular Release in patients with refractory frozen shoulder
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Yoshihiro Hagiwara, Akira Ando, Hiroyuki Sugaya, Norimasa Takahashi, Nobuaki Kawai, Junichiro Hamada, Eiji ItoiAbstract:Purpose The purpose of the study was to retrospectively determine the effects of intra-articular steroid injection on the clinical outcome of patients who underwent arthroscopic pan-Capsular Release for refractory frozen shoulder.
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effects of intra articular steroid injection before pan Capsular Release in patients with refractory frozen shoulder
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Yoshihiro Hagiwara, Akira Ando, Hiroyuki Sugaya, Norimasa Takahashi, Nobuaki Kawai, Junichiro Hamada, Eiji ItoiAbstract:The purpose of the study was to retrospectively determine the effects of intra-articular steroid injection on the clinical outcome of patients who underwent arthroscopic pan-Capsular Release for refractory frozen shoulder. Between 2000 and 2010, 34 patients (20 males, 14 females) who underwent an arthroscopic pan-Capsular Release for frozen shoulder were included. Intra-articular steroid injections were administered from April 2006, and just before surgery and at the final follow-up, ranges of motion (ROM) and scores of the Shoulder Rating Scale of the University of California, Los Angeles (UCLA) scoring system were evaluated. Intra-articular steroid injection significantly improved the UCLA scores of pain just before surgery and at the final follow-up (1.7 ± 0.5 vs. 6 ± 2, p < 0.0001). We subdivided the patients into those with and without diabetes mellitus. Steroid injection had a significant effect on the ROM in forward flexion (166.6 ± 8.6 vs. 140 ± 36.1, p = 0.026) and the scores of pain (10 vs. 9.3 ± 1.2, p = 0.046) at the final follow-up in the group without diabetes mellitus compared with those with it. Intra-articular steroid injection improves pain just before an arthroscopic pan-Capsular Release and at the final follow-up in all the patients with refractory frozen shoulder. However, it improves the ROM in forward flexion and the UCLA scores of pain at the final follow-up only in those without diabetes mellitus. Therapeutic studies, Level IV.
Janet D Conway - One of the best experts on this subject based on the ideXlab platform.
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treatment with posterior Capsular Release botulinum toxin injection hamstring tenotomy and peroneal nerve decompression improves flexion contracture after total knee arthroplasty minimum 2 year follow up
Knee Surgery Sports Traumatology Arthroscopy, 2020Co-Authors: Hamed Vahedi, Anton Khlopas, Vivian L Szymczuk, Melanie K Peterson, Ahmed I Hammouda, Janet D ConwayAbstract:Purpose No definite treatment option with reasonable outcome has been presented for old and refractory flexion contracture after total knee arthroplasty (TKA). We describe a surgical technique for 21 refractory cases of knee flexion contracture, including 12 patients with history of failed manipulation under anesthesia (MUA). Methods Retrospective review was conducted for procedures performed by a single surgeon between 2005 and 2016. Twenty-one knees (19 patients) with knee flexion contracture after primary TKA were treated with all the following procedures: posterior Capsular Release, hamstring tenotomy, prophylactic peroneal nerve decompression, and botulinum toxin type A injections. Twelve of the 21 knees had at least 1 prior unsuccessful MUA before this soft-tissue Release procedure. Mean age at intervention was 60 years (range 46-78 years). Mean preoperative knee range of motion (ROM) was - 27° extension (range - 20° to - 40°) to 100° flexion (range 90°-115°). All radiographs were evaluated for proper component sizing and signs of loosening. Results Full extension was achieved immediately after surgery in all patients. Only one knee required repeat botulinum toxin type A injection. All patients had full extension at mean follow-up of 31 months (range 24-49 months). No significant change was observed in knee flexion after the procedure (n.s.). Significant improvement was noted in the postoperative Knee Society Score (KSS) (mean 80, range 70-90) when compared with preoperative KSS (mean 45, range 25-65) (p = 0.008). Conclusion The proposed surgical technique is efficacious in treating patients with refractory knee flexion contracture following TKA to gain and maintain full extension at minimum 2-year follow-up. Level of evidence IV, retrospective case series.
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treatment with posterior Capsular Release botulinum toxin injection hamstring tenotomy and peroneal nerve decompression improves flexion contracture after total knee arthroplasty minimum 2 year follow up
Knee Surgery Sports Traumatology Arthroscopy, 2020Co-Authors: Hamed Vahedi, Anton Khlopas, Vivian L Szymczuk, Melanie K Peterson, Ahmed I Hammouda, Janet D ConwayAbstract:No definite treatment option with reasonable outcome has been presented for old and refractory flexion contracture after total knee arthroplasty (TKA). We describe a surgical technique for 21 refractory cases of knee flexion contracture, including 12 patients with history of failed manipulation under anesthesia (MUA). Retrospective review was conducted for procedures performed by a single surgeon between 2005 and 2016. Twenty-one knees (19 patients) with knee flexion contracture after primary TKA were treated with all the following procedures: posterior Capsular Release, hamstring tenotomy, prophylactic peroneal nerve decompression, and botulinum toxin type A injections. Twelve of the 21 knees had at least 1 prior unsuccessful MUA before this soft-tissue Release procedure. Mean age at intervention was 60 years (range 46–78 years). Mean preoperative knee range of motion (ROM) was – 27° extension (range – 20° to – 40°) to 100° flexion (range 90°–115°). All radiographs were evaluated for proper component sizing and signs of loosening. Full extension was achieved immediately after surgery in all patients. Only one knee required repeat botulinum toxin type A injection. All patients had full extension at mean follow-up of 31 months (range 24–49 months). No significant change was observed in knee flexion after the procedure (n.s.). Significant improvement was noted in the postoperative Knee Society Score (KSS) (mean 80, range 70–90) when compared with preoperative KSS (mean 45, range 25–65) (p = 0.008). The proposed surgical technique is efficacious in treating patients with refractory knee flexion contracture following TKA to gain and maintain full extension at minimum 2-year follow-up. IV, retrospective case series.
Yoshihiro Hagiwara - One of the best experts on this subject based on the ideXlab platform.
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clinical outcomes of arthroscopic pan Capsular Release with or without entire coracohumeral ligament Release for patients with frozen shoulder
JSES International, 2020Co-Authors: Yoshihiro Hagiwara, Akira Ando, Masashi Koide, Kenji Kanazawa, Takuya Sekiguchi, Yutaka Yabe, Norimasa Takahashi, Masaki Takahashi, Hiroyuki SugayaAbstract:Background We aimed to retrospectively determine the effects of arthroscopic pan-Capsular Release with or without entire coracohumeral ligament (CHL) Release and diabetes mellitus (DM) in patients with frozen shoulder (FS). Methods The study included 34 patients (20 male and 14 female patients) who underwent arthroscopic pan-Capsular Release without entire CHL Release (group 1) and 26 patients (6 male and 20 female patients) who underwent entire CHL Release for FS (group 2). Patients with a minimum of 12 months of follow-up were included, and range of motion (ROM) and the shoulder rating scale of the University of California at Los Angeles (UCLA) scoring system were evaluated. Results In group 2, external rotation and hand-behind-the-back (HBB) ROMs were significantly increased compared with group 1 at the final follow-up (external rotation, 53.1° ± 15.2° vs. 41.3° ± 20.5° [P = .044]; HBB level, T6 [interquartile range, T5-T9] vs. T11 [interquartile range, T8-L4] [P < .001]). Total UCLA scores and UCLA scores for pain (9.2 ± 1.5 vs. 10.0, P = .003), function (8.5 ± 1.4 vs. 10.0, P < .001), and active forward flexion (4.6 ± 0.6 vs. 4.9 ± 0.2, P < .011) were significantly greater in group 2 at the final follow-up. Patients without DM tended to have greater recovery of forward flexion and HBB ROMs and better total, pain, and function UCLA scores compared with those with DM. In group 2, there were no significant differences in ROMs and UCLA scores between the patients with DM and those without DM. Conclusion Arthroscopic entire CHL Release is an essential treatment option for FS patients to regain ROMs and function and to reduce pain.
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effects of joint Capsular Release on range of motion in patients with frozen shoulder
Journal of Shoulder and Elbow Surgery, 2020Co-Authors: Yoshihiro Hagiwara, Akira Ando, Masashi Koide, Kenji Kanazawa, Takuya Sekiguchi, Yutaka Yabe, Kazuaki Suzuki, Eiji ItoiAbstract:Background A thickened joint capsule is believed to be one of the most specific manifestations of and the primary restraint against range of motion (ROM) in frozen shoulders. The purpose of this study was to evaluate the relationship among ROMs under general anesthesia before surgery and the effects of each joint Capsular Release on ROM. Methods ROM was measured using a goniometer with scapular fixation. Arthroscopic pan-Capsular Release was performed with the patient in the beach-chair position in the following order: (1) rotator interval, (2) coracohumeral ligament, (3) superior capsule, (4) middle glenohumeral ligament, (5) anterior inferior glenohumeral ligament, and (6) posterior inferior glenohumeral ligament. ROMs in forward flexion (FF), lateral elevation (LE), external rotation with the arm at the side (ER1), external rotation at 90° of LE (ER2), internal rotation at 90° of LE (IR2), horizontal flexion, external rotation at 90° of FF (ER3), and internal rotation at 90° of FF (IR3) were evaluated before and after each Release. Results A total of 32 consecutive shoulders were included. After each Capsular Release, the ROM recovered; the final ROM was significantly greater on the affected side than on the unaffected side. Significant correlations were found between FF and LE, FF and ER1, ER1 and ER2, ER1 and ER3, ER2 and ER3, and IR2 and IR3 on both sides, regardless of surgery. Conclusion Each segment of the joint capsule affected ROM in all directions, supporting the need for whole-joint Capsular Release; ROM was significantly greater on the affected side than on the unaffected side after surgery.
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solitary bone cyst of the proximal humerus with a concomitant stiff shoulder treated with both arthroscopic Capsular Release and arthroscope assisted resection of the bone cyst a case report
Open Journal of Orthopedics, 2018Co-Authors: Akira Ando, Masashi Koide, Yoshihiro Hagiwara, Michimasa Matsuda, Eiji ItoiAbstract:Solitary bone cysts are benign bone lesions that usually occur in the humerus, calcaneus, and femur of children and adolescents. When present in adults, they are usually diagnosed as incidental findings. In this report, we present an adult case of a solitary bone cyst of the proximal humerus with concomitant refractory stiff shoulder treated with both arthroscopic Capsular Release and arthroscope-assisted resection of the bone cyst. A 73-year-old woman was referred with a complaint of persistent left shoulder pain and limited range of motion. Magnetic resonance imaging showed an approximately 4.5-cm long diameter cystic bone lesion from the humeral neck to the shaft. At first, arthroscopic synovectomy and pan-Capsular Release were performed. Next, two 1-cm skin incisions and 8-mm drill holes into the lateral wall of the cyst were created with fluoroscopic guidance. After insertion of the arthroscope through the holes, the white membranous cyst wall was resected with a shaver until bone marrow was observed. Finally, an 8-mm cannulated hydroxyapatite pin was inserted. This is a simple technique that allows direct visualization and complete resection of the cyst wall with two small incisions. Such a technique may be superior to conventional open procedures or those under image guidance.
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effects of intra articular steroid injection before pan Capsular Release in patients with refractory frozen shoulder
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Yoshihiro Hagiwara, Akira Ando, Hiroyuki Sugaya, Norimasa Takahashi, Nobuaki Kawai, Junichiro Hamada, Eiji ItoiAbstract:Purpose The purpose of the study was to retrospectively determine the effects of intra-articular steroid injection on the clinical outcome of patients who underwent arthroscopic pan-Capsular Release for refractory frozen shoulder.
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effects of intra articular steroid injection before pan Capsular Release in patients with refractory frozen shoulder
Knee Surgery Sports Traumatology Arthroscopy, 2015Co-Authors: Yoshihiro Hagiwara, Akira Ando, Hiroyuki Sugaya, Norimasa Takahashi, Nobuaki Kawai, Junichiro Hamada, Eiji ItoiAbstract:The purpose of the study was to retrospectively determine the effects of intra-articular steroid injection on the clinical outcome of patients who underwent arthroscopic pan-Capsular Release for refractory frozen shoulder. Between 2000 and 2010, 34 patients (20 males, 14 females) who underwent an arthroscopic pan-Capsular Release for frozen shoulder were included. Intra-articular steroid injections were administered from April 2006, and just before surgery and at the final follow-up, ranges of motion (ROM) and scores of the Shoulder Rating Scale of the University of California, Los Angeles (UCLA) scoring system were evaluated. Intra-articular steroid injection significantly improved the UCLA scores of pain just before surgery and at the final follow-up (1.7 ± 0.5 vs. 6 ± 2, p < 0.0001). We subdivided the patients into those with and without diabetes mellitus. Steroid injection had a significant effect on the ROM in forward flexion (166.6 ± 8.6 vs. 140 ± 36.1, p = 0.026) and the scores of pain (10 vs. 9.3 ± 1.2, p = 0.046) at the final follow-up in the group without diabetes mellitus compared with those with it. Intra-articular steroid injection improves pain just before an arthroscopic pan-Capsular Release and at the final follow-up in all the patients with refractory frozen shoulder. However, it improves the ROM in forward flexion and the UCLA scores of pain at the final follow-up only in those without diabetes mellitus. Therapeutic studies, Level IV.
Hamed Vahedi - One of the best experts on this subject based on the ideXlab platform.
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treatment with posterior Capsular Release botulinum toxin injection hamstring tenotomy and peroneal nerve decompression improves flexion contracture after total knee arthroplasty minimum 2 year follow up
Knee Surgery Sports Traumatology Arthroscopy, 2020Co-Authors: Hamed Vahedi, Anton Khlopas, Vivian L Szymczuk, Melanie K Peterson, Ahmed I Hammouda, Janet D ConwayAbstract:Purpose No definite treatment option with reasonable outcome has been presented for old and refractory flexion contracture after total knee arthroplasty (TKA). We describe a surgical technique for 21 refractory cases of knee flexion contracture, including 12 patients with history of failed manipulation under anesthesia (MUA). Methods Retrospective review was conducted for procedures performed by a single surgeon between 2005 and 2016. Twenty-one knees (19 patients) with knee flexion contracture after primary TKA were treated with all the following procedures: posterior Capsular Release, hamstring tenotomy, prophylactic peroneal nerve decompression, and botulinum toxin type A injections. Twelve of the 21 knees had at least 1 prior unsuccessful MUA before this soft-tissue Release procedure. Mean age at intervention was 60 years (range 46-78 years). Mean preoperative knee range of motion (ROM) was - 27° extension (range - 20° to - 40°) to 100° flexion (range 90°-115°). All radiographs were evaluated for proper component sizing and signs of loosening. Results Full extension was achieved immediately after surgery in all patients. Only one knee required repeat botulinum toxin type A injection. All patients had full extension at mean follow-up of 31 months (range 24-49 months). No significant change was observed in knee flexion after the procedure (n.s.). Significant improvement was noted in the postoperative Knee Society Score (KSS) (mean 80, range 70-90) when compared with preoperative KSS (mean 45, range 25-65) (p = 0.008). Conclusion The proposed surgical technique is efficacious in treating patients with refractory knee flexion contracture following TKA to gain and maintain full extension at minimum 2-year follow-up. Level of evidence IV, retrospective case series.
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treatment with posterior Capsular Release botulinum toxin injection hamstring tenotomy and peroneal nerve decompression improves flexion contracture after total knee arthroplasty minimum 2 year follow up
Knee Surgery Sports Traumatology Arthroscopy, 2020Co-Authors: Hamed Vahedi, Anton Khlopas, Vivian L Szymczuk, Melanie K Peterson, Ahmed I Hammouda, Janet D ConwayAbstract:No definite treatment option with reasonable outcome has been presented for old and refractory flexion contracture after total knee arthroplasty (TKA). We describe a surgical technique for 21 refractory cases of knee flexion contracture, including 12 patients with history of failed manipulation under anesthesia (MUA). Retrospective review was conducted for procedures performed by a single surgeon between 2005 and 2016. Twenty-one knees (19 patients) with knee flexion contracture after primary TKA were treated with all the following procedures: posterior Capsular Release, hamstring tenotomy, prophylactic peroneal nerve decompression, and botulinum toxin type A injections. Twelve of the 21 knees had at least 1 prior unsuccessful MUA before this soft-tissue Release procedure. Mean age at intervention was 60 years (range 46–78 years). Mean preoperative knee range of motion (ROM) was – 27° extension (range – 20° to – 40°) to 100° flexion (range 90°–115°). All radiographs were evaluated for proper component sizing and signs of loosening. Full extension was achieved immediately after surgery in all patients. Only one knee required repeat botulinum toxin type A injection. All patients had full extension at mean follow-up of 31 months (range 24–49 months). No significant change was observed in knee flexion after the procedure (n.s.). Significant improvement was noted in the postoperative Knee Society Score (KSS) (mean 80, range 70–90) when compared with preoperative KSS (mean 45, range 25–65) (p = 0.008). The proposed surgical technique is efficacious in treating patients with refractory knee flexion contracture following TKA to gain and maintain full extension at minimum 2-year follow-up. IV, retrospective case series.
Jon J P Warner - One of the best experts on this subject based on the ideXlab platform.
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Capsular Release following total shoulder arthroplasty an analysis of early outcomes
European Journal of Orthopaedic Surgery and Traumatology, 2021Co-Authors: Eric R Wagner, Michelle J Chang, Muriel J Solberg, Kathryn M Welp, Tyler J Hunt, Jarret M Woodmass, Laurence D Higgins, Jon J P WarnerAbstract:The purpose of this study is to analyze the outcomes of open and arthroscopic Capsular Release following total shoulder arthroplasty. Over 15 years, 19 patients experienced persistent shoulder stiffness after anatomic total shoulder arthroplasty refractory to nonoperative treatment, requiring either open (n = 5) or arthroscopic (n = 14) Capsular Release. There were seven (39%) patients who had a prior diagnosis of stiffness before the primary arthroplasty. At a follow-up of 2.3 years (1–5.5), there were changes in range of motion, including forward flexion (77°–117°), abduction (49°–98°), external rotation (9°–19°), internal rotation at 0° (Sacrum to L1), and pain (4.1–2.3) scores (p < 0.01). There were seven (37%) patients that required a reoperation following the initial Capsular Release. The survival-free of reoperation at 2 and 5 years was 76% and 53%, respectively, while the survival-free of revision surgery at 2 and 5 years was 83%. Furthermore, three (16%) patients required a repeat Capsular Release. Overall, there were 11 (58%) complications, including stiffness (n = 9), infection (n = 1), subscapularis rupture (n = 2), glenoid loosening (n = 3), and pain with weakness requiring reoperation (n = 1). Shoulder stiffness after total shoulder arthroplasty is a very difficult pathology to treat, with high rates of complications and reoperations after Capsular Release. Overall, in patients that do not develop glenoid loosening, Capsular Release does improve the patient’s pain and shoulder motion. Furthermore, when patients develop stiffness, it is critical to rule out other etiologies, such as glenoid loosening, prior to proceeding with Capsular Release. Retrospective case series.
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Capsular Release following total shoulder arthroplasty an analysis of early outcomes
European Journal of Orthopaedic Surgery and Traumatology, 2020Co-Authors: Eric R Wagner, Michelle J Chang, Muriel J Solberg, Kathryn M Welp, Tyler J Hunt, Jarret M Woodmass, Laurence D Higgins, Jon J P WarnerAbstract:BACKGROUND The purpose of this study is to analyze the outcomes of open and arthroscopic Capsular Release following total shoulder arthroplasty. METHODS Over 15 years, 19 patients experienced persistent shoulder stiffness after anatomic total shoulder arthroplasty refractory to nonoperative treatment, requiring either open (n = 5) or arthroscopic (n = 14) Capsular Release. There were seven (39%) patients who had a prior diagnosis of stiffness before the primary arthroplasty. RESULTS At a follow-up of 2.3 years (1-5.5), there were changes in range of motion, including forward flexion (77°-117°), abduction (49°-98°), external rotation (9°-19°), internal rotation at 0° (Sacrum to L1), and pain (4.1-2.3) scores (p < 0.01). There were seven (37%) patients that required a reoperation following the initial Capsular Release. The survival-free of reoperation at 2 and 5 years was 76% and 53%, respectively, while the survival-free of revision surgery at 2 and 5 years was 83%. Furthermore, three (16%) patients required a repeat Capsular Release. Overall, there were 11 (58%) complications, including stiffness (n = 9), infection (n = 1), subscapularis rupture (n = 2), glenoid loosening (n = 3), and pain with weakness requiring reoperation (n = 1). CONCLUSIONS Shoulder stiffness after total shoulder arthroplasty is a very difficult pathology to treat, with high rates of complications and reoperations after Capsular Release. Overall, in patients that do not develop glenoid loosening, Capsular Release does improve the patient's pain and shoulder motion. Furthermore, when patients develop stiffness, it is critical to rule out other etiologies, such as glenoid loosening, prior to proceeding with Capsular Release. LEVEL OF EVIDENCE IV Retrospective case series.
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arthroscopic Capsular Release for refractory shoulder stiffness a critical analysis of effectiveness in specific etiologies
Journal of Shoulder and Elbow Surgery, 2010Co-Authors: Bassem T Elhassan, Laurence D Higgins, Mehmet Ugur Ozbaydar, Daniel F Massimini, Jon J P WarnerAbstract:Hypothesis The purpose of this study is to report and compare the outcome of arthroscopic Capsular Release in patients with shoulder stiffness with post-traumatic, postsurgical, and idiopathic etiologies. We hypothesize that patients with idiopathic or post-traumatic stiffness have better outcomes after arthroscopic Capsular Release than those with shoulder stiffness with a postsurgical etiology. Materials and Methods A retrospective review of 115 patients who underwent arthroscopic Capsular Release for refractory shoulder stiffness was performed. There were 60 men and 55 women with a mean age of 49 years (range, 27 to 81 years). The patients were divided into 3 groups according to the etiology of stiffness: post-traumatic (26 patients), postsurgical (48 patients), and idiopathic (41 patients). Arthroscopic Capsular Release was performed in all patients after a mean of 9 months of physical therapy (range, 6 to 13 months). Results At a mean follow-up of 46 months (range, 25 to 89 months), the overall subjective shoulder value in all groups improved from 29% to 73% and the age- and gender-adjusted Constant score improved from 35% to 86%. The mean pain score decreased from 7.5 to 1, and mean active forward flexion, external rotation, and internal rotation increased from 97°, 14°, and the L5 vertebral level, respectively, to 135°, 38°, and the T11 vertebral level, respectively ( P P = .7). However, the Constant score and subjective shoulder value were significantly lower in the postsurgical group compared with the idiopathic and post-traumatic groups ( P = .0001 and P = .006, respectively). Conclusions Arthroscopic Capsular Release is an effective treatment for refractory shoulder stiffness. Patients with idiopathic and post-traumatic shoulder stiffness have better outcomes than patients with postsurgical stiffness.